Smoking, Drinking and Drug Use among Young People in England, 2023

This document constitutes a background quality report for Smoking, Drinking and Drug Use Amongst Young People in England (SDD). The statistics included in this release are the latest available figures at the time of publication. 

Context

This is the latest in the series of surveys of secondary school children in England which provides the national estimates of the proportions of young people aged 11 to 15 who smoke, drink alcohol or take illicit drugs.  As well as providing prevalence rates it also provides information on sources of cigarettes, alcohol and illicit drugs as well as attitudes towards their use.  

The report is published on the NHS England website.

 

Purpose of document

This paper aims to provide users with an evidence based assessment of the quality of the statistical outputs included in this report.  

It reports against the nine European Statistical System (ESS) quality dimensions and principles¹ appropriate to this output. In doing so, this meets NHS England’s obligation to comply with the UK Statistics Authority (UKSA) Code of Practice for Statistics, and the following principles in particular:

• Trustworthiness pillar, principle 6 (Data governance) which states “Organisations should look after people’s information securely and manage data in ways that are consistent with relevant legislation and serve the public good.”
• Quality pillar, principle 3 (Assured Quality) which states “Producers of statistics and data should explain clearly how they assure themselves that statistics and data are accurate, reliable, coherent and timely.”
• Value pillar, principle 1 (Relevance to Users) which states “Users of statistics and data should be at the centre of statistical production; their needs should be understood, their views sought and acted on, and their use of statistics supported.”
• Value pillar, principle 2 (Accessibility) which states “Statistics and data should be equally available to all, not given to some people before others. They should be published at a sufficient level of detail and remain publicly available.” 

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¹The original quality dimensions are: relevance, accuracy and reliability, timeliness and punctuality, accessibility and clarity, and coherence and comparability; these are set out in Eurostat Statistical Law. However more recent quality guidance from Eurostat includes some additional quality principles on: output quality trade-offs, user needs and perceptions, performance cost and respondent burden, and confidentiality, transparency and security. 

This dimension covers the degree to which the statistical product meets user needs in both coverage and content.

Towards a smoke-free generation: tobacco control plan for England mentions SDD as the source of information on children smoking and  one of the objectives stated in the plan is to “reduce the number of 15 year olds who regularly smoke from 8% to 3% or less”.  Progress against this objective will be measured by this survey.

It is also used to monitor indicators C13a and C13b at national level in the Public Health Outcomes Framework (PHOF). The report covers England only. 

From our engagement with customers, we know that there are many other users of these statistics, details of which can be found in Appendix D.

 

This dimension covers, with respect to the statistics, their proximity between an estimate and the unknown true value.

Sampling error and confidence intervals

As the data are based on a sample (rather than a census) of pupils, the estimates are subject to sampling error. A range of uncertainty can be placed around the survey estimate which is called the Confidence Interval. Appendix B2 has details on the sampling errors and confidence intervals for this survey, and the confidence interval excel tables include true standard errors, confidence intervals and design effects calculated for key survey estimates.

In general, attention is drawn to differences between estimates only when they are significant at the 95% confidence level, thus indicating that there is less than 5% probability that the observed difference could be due to random sampling variation when no difference occurred in the population from which the sample is drawn.

The limitations of the survey estimates are discussed in Appendix B1.

Presentation of unreliable estimates in data tables

Estimates calculated from a small sample base of pupils (the denominator) are less reliable and will be subject to wider confidence intervals. In the data tables, where a base is between 30 and less than 50, the estimate is shown in square brackets to indicate a low level of reliability e.g. [34]. Where a base is below 30 then the estimate is replaced with a 'u' to indicate that the estimate is considered unreliable.

Records excluded from the dataset

Questions about awareness and use of the fictional drug semeron have been included in the SDD survey for a number of years to attempt to identify instances of over-reporting.

Pupils who reported smoking cigarettes or drinking alcohol in the last 7 days are asked to report the following:

• for smoking, the number of cigarettes smoked per day for each of the last 7 days. Pupils could enter values between 0 and 50 per day.
• for drinking alcohol, the total number of each of a range of different types and measures of alcohol drinks, such as pints of beer, cans of cider or glasses of wine, in the last 7 days and on which of the last 7 days they drank alcohol

Initial analysis of the 2023 data identified that some pupils had reported extremely unlikely high quantities of cigarettes smoked or alcohol measures consumed in the previous 7 days.

For this report we have excluded pupils’ data from all parts of the report where their responses included one or more of the following:

• offered or tried semeron
• 49 or more cigarettes smoked on any of the last 7 days
• 49 or more of any measure of alcohol in the last 7 days
• a number of every measure of beer and lager, cider, wine, spirits and alcoholic premixed drinks (14 different measures in total) in the last 7 days
• over 50 units of alcohol per reported day of drinking (calculated total number of units in the last 7 days divided by the number of days the pupil reported drinking alcohol)

Together these 5 rules excluded 195 of the 13,387 pupils from sampled schools who took part in the survey. The number of survey responses excluded by each rule is shown in Table 1 below.

 

Table 1 – Number of pupils excluded by each over-reporting rule, 2023

Many of the pupil surveys identified for exclusion fall within more than 1 of the 5 exclusion groups, providing additional evidence that these rules detect over-reporting.

Mean and median values for cigarettes smoked or units of alcohol consumed

Previous SDD survey reports have included analysis of the mean number of cigarettes smoked by pupils who reported smoking in the last 7 days, and the mean number of units of alcohol consumed by pupils who reported drinking in the last 7 days.

The mean number of cigarettes or units of alcohol can be influenced by relatively small amounts of over-reported high values. While we have excluded some survey responses with obviously implausible values, less obvious over-reporting of cigarette and alcohol consumption will not be detected and excluded by this method. Therefore, changes in the mean values compared to previous years may still be heavily influenced by a small number of high values. The 2023 report will report median quantities rather than means as this measure is much less likely to be affected. For total cigarettes smoked, this continues a time series allowing comparisons over time.

Timeliness refers to the time gap between publication and the reference period. Punctuality refers to the gap between planned and actual publication dates.

The survey relates to the academic autumn term of 2023. However, as happened in previous surveys, fieldwork was extended into the following calendar year (up to March 2024) in order to increase response rates.  This is discussed more fully in Appendix B.  

This report was released on the pre-announced publication date.

Accessibility is the ease with which users are able to access the data, also reflecting the format in which the data are available and the availability of supporting information. Clarity refers to the quality and sufficiency of the metadata, illustrations and accompanying advice.

This report can be printed as a PDF using the functionality on the front page. All tables in the report are provided in Excel format.  

The publication may be requested in large print or other formats through the NHS England contact centre: [email protected] (please include ‘SDD’ in the subject line).

NHS England has produced SDD reports since 2004.  Prior to this the Department of Health produced these reports. 

Coherence is the degree to which data which have been derived from different sources or methods but refer to the same topic are similar. Comparability is the degree to which data can be compared over time and domain.

Survey mode - school versus home based

The mode used to collect survey data on smoking, drinking and use of illicit drugs can affect how pupils may answer the questions.  For example, they may be more willing to admit to some of these behaviours in surveys conducted away from the pupil’s home.  Previous analysis has shown SDD to provide the most accurate measures of undertaking in risky behaviours as it is conducted away from the home environment.  More information is available in section A8 of Health and Wellbeing of 15-year-olds in England - Main findings from the What About YOUth? Survey 2014.

There is information on comparisons with other sources at the end of parts 1, 5 and 8.

Survey topic content

The first survey in the series, carried out in 1982, measured the prevalence of smoking among pupils and described their smoking behaviour.

Questions on alcohol consumption were added to the survey in 1988.

The 1998 survey was the first to include questions on the prevalence of drug use.  

Questions about pupils’ wellbeing have been asked in their current form since 2018, with additional questions about loneliness from 2023.

Survey mode for 2023

Up to and including 2021, pupils completed an anonymous paper questionnaire in school, under exam conditions. Completed questionnaires were scanned and processed by the survey provider. For 2021, survey sessions were led by interviewers from Ipsos in some schools, and class teachers in other schools.

The 2023 survey was administered online. Information about the development of the 2023 online survey is in Appendix A.

As in earlier SDD survey years, schools were asked to sample one class from Years 7 and 8, and two classes from Years 9, 10 and 11. More classes were sampled in the older year groups to increase the precision of estimates. Maintaining the sampling approach will ensure that the data is directly comparable to earlier surveys and time series are preserved.

Change to a single survey questionnaire

For earlier SDD surveys there were two versions of the paper survey questionnaire, one with a focus on smoking and alcohol and the other with a focus on drug use. This design was used to reduce the time taken within a school lesson for pupils to complete the paper questionnaire.

For the 2023 online survey, all pupils completed the same questionnaire. This was possible because pupils were routed to relevant sections based on their question answers, so it took them less time to complete the survey. In addition, a full review of the questionnaire was undertaken in the planning stage, with a number of questions being removed to shorten the time it would take to complete.

Where more pupils answered a question, the precision of estimates based on that question will generally be increased compared to previous SDD surveys.

Question routing

For 2021 and earlier paper surveys, pupils had to follow complex routing instructions. This could result in missing questions or take pupils more time to understand, so they did not complete the whole questionnaire.

Changing to an online survey for 2023 is expected to improve data quality because pupils were automatically routed to the next relevant question based on their answers. Pupils could answer ‘Prefer not to say’ or ‘Don’t know’ to move on to the next relevant question. (For some questions these response options were only shown if the ‘next’ button was clicked without a response being given.)

The impact of automatic question routing will vary between questions. There are expected to be fewer missing values, and where the ‘Prefer not to say’ or ‘Don’t know’ options were not immediately available, more specific responses. However, some pupils may have dropped out of the survey if they wished to skip a question completely but could not.

Analysis that requires answers to multiple questions may be able to include an increased number of pupils because the routing has ensured that relevant questions are not missed out.

Changes to questionnaire content

NHS England and Ipsos reviewed the 2021 survey questionnaire and agreed with the SDD survey steering group which questions should be removed, changed or added. Questions were further updated following feedback from piloting the survey.

Appendix A9 lists all changes to the questionnaire.

For most of the questions that were removed, the associated tables or parts of tables from the 2021 survey report can no longer be produced for 2023.

For some analysis, the methodology could be amended to produce tables using different questions.

The impact of the changes on comparability over time has been considered throughout the report and tables. For some of the changes, the degree of change means that time series cannot be continued.

For other changes, data is still expected to be comparable over time, and footnotes indicate where the changes to the survey should be considered when interpreting the data.

All explanations below relate to 2023 changes unless otherwise stated.

Demographics

Gender categories and terminology

 In the 2021 SDD survey, pupils were asked “Are you a boy or a girl?”. Feedback from schools participating in SDD 2021 was that this question was not inclusive and needed to allow a wider a set of responses. For the 2023 SDD survey pupils were asked “Which of the following best describes your gender?” with the response options of “Boy”, “Girl”, “Non-binary”, “My gender is not listed” and “Prefer not to say”. These categories are used in other school surveys.The updated question does not represent a break in the time series for boys and girls, as the previous question collected pupils’ self-declared gender responses. In this report we refer to gender instead of sex, to more accurately described the data that has been collected.

Breakdowns based on the new question include the category “Another gender identity”, which includes pupils who selected the “Non-binary” and “My gender is not listed” responses. The combined category will help ensure that the sample size is large enough to present estimates for this gender in many of the outputs in the publication. For time series this category is shown from 2023 onwards.

Ethnicity

For the 2023 survey, “Roma” was added as a response option to align with the 2021 Census. In the report tables, this is included in the “White” category.  It is not known how pupils of this ethnicity would have described themselves in previous surveys.

Drinking alcohol

Break in time series: types of alcohol

The types of alcoholic drink that pupils were asked about were updated for 2023.

Previously pupils were asked about their consumption of “Beer, lager and cider” in the last 7 days as a single category of alcoholic drink. The questions were changed to ask about consumption of “Beer and lager” and “Cider” as separate categories. Also, where pupils were previously asked about their consumption of “alcopops”, the question was changed to ask about “alcoholic pre-mixed drinks”. Consumption of shandy was no longer asked about.

Due to the number of changes to types of drink, a new time series for types of alcohol drunk in the last week has been started from 2023. The time series up to 2021 is included in the tables for reference. Data may be comparable over time for “Wine, martini and sherry” and “Spirits” as there were no changes to the way these drinks were asked about.

Break in time series: alcohol unit calculations

Pupils enter the quantity of each measure of each type of drink they consumed in the last 7 days, and we convert these quantities into units of alcohol.

Following recommended changes for the Health Survey for England (https://digital.nhs.uk/data-and-information/areas-of-interest/public-health/health-survey-for-england-2022-alcohol-consumption-methodology-changes-to-alcohol-unit-conversion-factors), the conversion factors used in SDD calculations for units of beer and lager, cider and wine, martini and sherry were updated for the 2023 report.

Table 2 below shows the conversion factors used previously for beer, lager and cider, and those used for 2023 for the separate categories of beer and lager, and cider.

 

Table 2 - Conversion factors for beer, lager and cider in 2023 and previous SDD surveys

A glass of wine, martini or sherry was converted to 2.2 units (previously 2 units).

Whilst the updated conversion factors will provide better estimates of the number of units consumed taking into account changes to the strengths and measures of drinks, data on the number of units consumed for 2023 is not comparable to previous years.

A new time series for units of alcohol consumed in the last week has been started from 2023. The time series up to 2021 is included in the tables for reference.

The conversion factors will tend to result in higher numbers of units for the same reported number of measures, but this should not be interpreted as a sudden change in actual consumption by pupils between 2021 and 2023.

Break in time series: Whether and how pupils obtained alcohol

The analysis in the report of whether and how pupils obtained alcohol in the last 4 weeks brings together the answers from multiple questions relating to obtaining alcohol:

• from a shop, supermarket or off-licence
• in a pub, bar or club
• by being given it by another person
• by taking or stealing it

For 2023, pupils who said they had never had an alcoholic drink were not asked about being given or taking alcohol. The analysis from 2023 is therefore based only on pupils who had answered “Yes” or “Prefer not to say” to the question “Have you ever had an alcoholic drink?”.  We would expect pupils who had never drunk alcohol to be less likely to have obtained alcohol in the last 4 weeks than pupils who have drunk alcohol at some time. Percentages for each source of alcohol and overall would therefore be expected to be higher than for all pupils when those pupils who had not drunk alcohol are excluded. Data from 2023 based on pupils who had ever had a drink is therefore not comparable to data from previous surveys based on all pupils.

We also show the proportion of those pupils who obtained alcohol in the last 4 weeks that obtained it from each source. We expect this analysis to be more consistent over time, as in previous surveys the majority of pupils that obtained alcohol also said they had drunk alcohol before.

Break in time series: Parental awareness of and attitude to pupil’s drinking

Prior to 2023, all pupils were asked about their parents’ attitude to the pupil drinking alcohol. If pupils currently drank alcohol, they were asked how their parents felt, and if they said their parents did not know that they drank, they were asked how they thought their parents would feel if they knew. If pupils said they never drink alcohol, they were asked how they thought their parents would feel if they started.

For 2023, pupils who said they never drink alcohol were not asked about their parents’ attitude. Also, pupils who drank but said their parents did not know were not asked what their parents would think if they knew.

The 2023 report and tables include only data for current drinkers. This is not comparable to data for current drinkers for previous years because those who said their parents did not know are now a separate category.

Break in time series: change to alcohol questions (2016)

The question wording which is used both for the “ever drunk alcohol” prevalence indicator and as a filter question for further questions about alcohol use changed from 2016.  Previously the question wording was “Have you ever had a proper alcoholic drink – a whole drink, not just a sip? Please don’t count drinks labelled low alcohol?”

However, during cognitive testing of the survey pupils expressed confusion around the terms “proper alcoholic drink” and “low alcohol”.  Some pupils reported excluding alcopops and cocktails containing alcohol as they generally tasted of fruit rather than alcohol. As a result, it was decided to remove those terms and therefore the question became “Have you ever had an alcoholic drink - a whole drink, not just a sip?”.

Therefore, whilst this change of wording will deliver a better estimate of the number of children who do drink alcohol it does mean that the results from 2016 onwards are not comparable with previous years. The chapters which include estimates based on the alcohol questions and the tables they are based on have been annotated to mention this. To a lesser extent, this may also affect estimates produced from other alcohol related questions. This is because a slightly wider group of children will now answer these questions, who may have been filtered out of the further alcohol questions based on the previous wording. 

Drug use

Drug prevalence changes (2016 and 2023)

The following should be taken into account when looking at changes over time for the drug prevalence measures in part 8; ever taken drugs, taken drugs in the last year and taken drugs in the last month (tables 8.1 to 8.8): 

1. Questions on psychoactive substances, which include new psychoactive substances (NPS), previously known as legal highs, and Nitrous Oxide (laughing gas), were included in the calculation of the overall prevalence of drug use measures (ever used, used in last year, used in last month) from 2016. Both are covered by the Psychoactive Substances Act 2016 which restricts the production, sale and supply of such substances.  
When psychoactive substances are removed from the measure, the overall drug prevalence figure for 2016 falls by 3 percentage points (24.3% to 21.3%). This adjusted version is included as an extra measure in the time series data shown in tables 8.6 to 8.8.  

2. In 2016, even when accounting for the addition of psychoactive substances to the measures, there was a large and unexpected rise in the overall drug use prevalence reported; 14.6% in 2014, to 24.3% in 2016.  

Further investigations identified that some of this change had been driven by an increased likelihood since 2016 of pupils who said yes to having heard of individual drug types, then not going on to answer questions on whether they had tried them. The overall drug prevalence measure is derived using the responses from these individual drug types (see Appendix C), and so this results in a greater proportion of pupils being excluded from the denominator, as their drug use was considered to be unknown. A pupil not providing a response for just one of the 17 drug types asked about can result in them being excluded from the overall prevalence calculation; the proportion with an unknown overall drug use status increased from 8% in 2014, to 21% in 2016.

Cross checking with a further summary question, pupils’ are asked whether they had ever tried any drug, indicates that most of these pupils had not tried any drugs. Thus, the overall impact of having removed these pupils from the indicator would likely be to increase the prevalence rates.

Neither the reason for this, nor how much of the change in prevalence between 2014 and 2016 this accounts for, is clear. However, some level of genuine increase was still apparent. If the overall drug use prevalence figure were to be adjusted based on the response to the summary drug use question, then the estimated prevalence for 2016 would be 21.5%. However, due to the amount of uncertainty in deriving this figure, it has not been presented in the publication.

Non-response proportions in 2018 and 2021 were around the same magnitude: 20% in 2018, and 22% in 2021.

For 2023, the proportion with an unknown overall drug use status fell to 11%. This is likely to be due to the question routing in the online survey ensuring that pupils answer the follow up questions for each drug that they said they had heard of.

It is not known how much of the change in prevalence from 2021 to 2023 this accounts for.

The increase in non-response from 2016 and subsequent fall in 2023 also affects prevalence measures for individual drug types, though to a lesser extent. This is because a pupil not answering a question for one drug type (and so being excluded from the overall prevalence calculation), will not impact their inclusion for other drug types about which they did provide a response.  

Other drug time series data in the report is not affected as it is derived from different questions e.g. usual frequency of drug use. The affected tables have been footnoted.

Break in time series: Number of occasions of drug use

Prior to 2023, the survey asked pupils “When did you last take drugs?” and those who said within the last year were asked “On how many occasions have you taken drugs?” with the response options “Once”, “2-5 occasions”, “6-10 occasions” and “More than 10 occasions”. This question was removed from the 2023 survey.

Pupils who had used or tried individual drugs (such as cannabis) continued to be asked about the number of occasions they had used or tried that drug, with the same set of response options. All pupils who had used or tried each drug were asked about occasions, not only those who said they had used it in the last year.

For some combinations of responses relating to individual drugs, we can derive an overall number of occasions:

• Once – if there is exactly one “Once” response for individual drugs
• 2 or more occasions – if there is one or more “2-5 occasions”, “6-10 occasions” or “More than 10 occasions” response for individual drugs.

Where a pupil gives the number of occasions individually for more than one drug, we cannot tell from the survey if and how far those occasions overlap. For example, responses of “Once” for two different drugs could represent one single occasion when both drugs were taken, or that each drug was taken on a different occasion. The overall number of occasions cannot be derived.

Similarly, responses of “6-10 occasions” for two different drugs could represent any number between 6 and 20 occasions of drug use. While a response of “More than 10 occasions” of using one drug could be counted as “More than 10 occasions” overall, it would be misleading to show this as a category because of the uncertainty over which other pupils would also be included in this category if the exact numbers of occasions and the extent of overlap were known. This means that all pupils who reported taking one or more drugs on more than one occasion can only be reported as taking drugs on “2 or more occasions” without further breakdown.

As the answers that we use to derive the total number of occasions are now collected from all pupils who have taken drugs, the majority of the occasions analysis in the report is no longer limited to pupils who took drugs in the last year. It will therefore include a wider group of pupils. There are a small number of tables that are filtered to include only pupils who took drugs in the last year (using the same method for defining “took drugs in the last year” as in the prevalence tables), and these are clearly labelled in the table headings.

The changes to the way that the number of occasions of drug use is recorded and can be analysed mean that the 2023 data is not comparable to that for earlier surveys.

Most recent occasion of drug use

Prior to 2023, the survey asked pupils “When did you last take drugs?” and those who said within the last year were asked further questions about the last time they took drugs, such as the drug taken, from whom they got drugs and why they took drugs on those occasions.

For 2023, the overarching question was not asked. Pupils who said they had taken any of the individual drugs were asked the further questions about the last time they took drugs, regardless of when they last took drugs. Potentially a larger group of pupils will be included in the analysis of the most recent occasion of drug use.

Although all pupils who have taken drugs are asked about their last occasion of drug use, we limit the analysis of the most recent occasion of drug use to pupils who have used drugs more than once, so that it is distinct from their first occasion. For 2023, pupils who have taken drugs more than once are identified using the new method for total occasions described above.

First occasion of drug use

Prior to 2023, the survey asked pupils “Have you ever used or taken any drugs?” and those who said they had were asked further questions about the first time they took drugs, such as the drug taken, from whom they got drugs and why they took drugs on those occasions.

For 2023, the overarching question was not asked. Pupils who said they had taken any of the individual drugs were asked the further questions about the first time they took drugs.

Usual frequency of drug use

One of the categories that we derive for usual frequency of drug use is “Taken drugs in the last year but only ever taken drugs once”.

Prior to 2023, this was based on the overarching questions “When did you last take drugs?” and “On how many occasions have you taken drugs?”.

For the 2023 survey, this category is derived based on each pupil’s answers to the questions about individual drugs – if they said they had used any of the individual drugs in the last year, and if they gave exactly one “Once” response for the number of occasions across all the individual drugs.

Data shown for this category may not be comparable over time.

Classification of amphetamines

Prior to 2023, if pupils said they had taken amphetamines, the survey asked a further question about how they were usually taken. This allowed injected amphetamines to be included in the Class A drug category.  

For 2023, the supplementary question was not asked. This report counts all amphetamine use as Class B drug use.

This change is expected to have had a very small effect on the reported figures for Class A drug use, based on the proportion of amphetamine use reported as injected in 2021.

For 2023, amphetamines were also counted as Class B drugs in the analysis of drugs offered, and drugs taken on the first or most recent occasion of drug use.

Perceived family attitude to pupil taking drugs

Prior to 2023, all pupils were asked about their family’s attitude to the pupil taking drugs. If pupils said they took drugs, they were asked how their family felt, and if they said their family did not know that they took drugs, they were asked how they thought their family would feel if they knew. If pupils didn’t take drugs, they were asked how they thought their family would feel if they started.

For 2023, pupils who took drugs and said their family did not know were not asked what their family would think if they knew. To reflect this change and to align the perceived attitude tables for all behaviours, the 2023 tables include categories for pupils who took drugs and said their family did not know, and for pupils who answered “Don’t know”.

For analysis of perceived family attitudes across all pupils, these changes should only have a small effect on comparability over time because they mainly affect the data for the subset of pupils who take drugs.

Analysis limited to pupils who have taken drugs is less likely to be comparable over time, as in addition to these changes it is also no longer limited to pupils who said they had taken drugs on more than one occasion.

Smoking

Pupils asked about accessing help or services to give up smoking

In the 2023 survey, ex-smokers were not asked the question “Have you ever done any of the following things to help you give up smoking?”.  This report only includes analysis of this question for current smokers.

Break in time series: Perceived family attitude to pupil’s smoking

Prior to 2023, all pupils were asked about their family’s attitude to the pupil smoking. If pupils did smoke, they were asked how their family felt, and if they said their family did not know that they smoked, they were asked how they thought their family would feel if they knew. If pupils didn’t smoke, they were asked how they thought their family would feel if they started smoking.

For 2023, not all smokers were asked about their family’s attitude. Also, pupils who smoked but said their family did not know were not asked what their family would think if they knew.

The 2023 report and tables include only data for current smokers. This is not comparable to data for current smokers for previous years because those who said their family did not know are now a separate category.

School lessons

Teacher survey completion rate

The survey includes a questionnaire completed by a teacher at each school about school lessons about smoking, alcohol and drugs. Some analysis of the teacher survey is included in Part 12 of this report (School lessons and guidance).

For 2023, responses to the teacher survey were received from 78 out of 185 schools (42%). This is a lower completion rate than for 2021, when 86% of participating schools responded to the teacher questionnaire (102 out of 119 schools).

The reduced participation in the teacher survey should be taken into account when comparing data from this section over time.

This dimension describes the extent to which different aspects of quality are balanced against each other.

Partaking in smoking, drinking alcohol or taking illicit drugs is self-reported by the pupil and therefore may be susceptible to “satisficing” where they give an answer which is more socially acceptable, i.e. to say they don’t do any of these things. Similarly they may be influenced to say they do partake in these behaviours to impress their peers.

Analysis of data from Health Survey for England showed that examining cotinine levels in saliva can lead to higher estimates of smoking prevalence amongst children than self-reported data. See the topic report on children’s smoking in the 2017 survey. However, this is a costly way to collect this information and difficult to carry out in schools within the time they are able to allocate to completion of the survey.

This dimension covers the processes for finding out about users and uses and their views on the statistical products.

User needs have been gathered and considered at all points in the collection and publication of this information. This has been guided by a steering group consisting of representatives from NHS England, Department of Health and Social Care, Department for Education, Office for Health Improvement and Disparities, The Home Office, PSHE Association, Liverpool John Moores University, UK Youth, Local Government Association.

The content of the survey and report are often consulted on. The most recent SDD consultation took place in May 2021 and the results of that consultation have fed into the design and questionnaire content of the 2023 survey.

Previously an SDD consultation took place in November 2015 and the results of that consultation fed into the design of the 2016, 2018 and 2021 surveys. For the 2018 survey, an update to the questions on pupil wellbeing in order to standardise them with those used by the Office for National Statistics was approved by the SDD steering group in November 2017.

The style of the report was also part of a wider consultation on outputs in 2016. The proposal for SDD was in section A8.

NHS England is keen to gain a better understanding of the users of this publication and of their needs; feedback is welcome and may be sent to [email protected] (please include ‘Smoking, Drinking and Drugs Survey’ in the subject line).

This dimension describes the effectiveness, efficiency and economy of the statistical output.

Data were collected from pupils using a self-completion online questionnaire.  Prior to 2023, pupils completed the questionnaire on paper. The online survey approach is designed to make the survey easier for schools to administer, and easier for pupils to complete within a single school period.  The time taken to complete the survey online is expected to be less than 30 minutes, compared to 40-50 minutes for the paper version. The time taken by individual pupils to complete the questionnaire was not recorded and it is not possible to estimate an average. 

The total cost of developing and running the survey and publishing the report is around £420,000.

The procedures and policy used to ensure sound confidentiality, security and transparent practices.

No personal/individual level information is received by NHS England or contained in the report. The list of schools which take part is maintained by the survey contractor and not known to NHS England.

The respondent level file available via the UK Data Service does not contain any personally identifiable data and has undergone disclosure control measures to mitigate against individuals being identified. It is also only disseminated under an End User Licence which contains terms and conditions on who can use the data and how the data may be stored and used. Specifically, the data can only be accessed by people from central or local government, Higher/Further Education and research charities. The terms and conditions also forbid onward sharing of the dataset and attempts to identify individuals.

This report and dissemination of the data via the UK Data Service are subject to a NHS England risk assessment prior to issue which is signed off by the Government Statistical Service Head of Profession for statistics.

The data contained in this publication are Accredited Official Statistics. The code of practice for official statistics is adhered to from collecting the data to publishing.

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